MOLLUSCUM CONTAGIOSUM

This leaflet has been written to help you understand more about molluscum contagiosum. It will tell you what it is, what causes it, what can be done about it, and where you can find out more about it.

What is molluscum contagiosum?

Molluscum contagiosum is a common and generally harmless condition that causes spots on skin. It is most common in children and young adults.

What causes molluscum contagiosum?

Molluscum contagiosum is caused by a pox virus. It can spread to others if the spots are in direct contact with someone else or they share the same item such as a towel. The spots usually appear a few weeks later. They are more common and extensive in people who have eczema. Sometimes people whose immune system is suppressed for any reason, such as by HIV infection or through taking immunosuppressive treatments may develop large numbers of molluscum spots, but most people with molluscum contagiosum are generally in good health.

Is molluscum contagiosum hereditary?

No, although it can affect several members of a family at the same time.

What are its symptoms?

Sometimes they can be itchy but most of the time they are asymptomatic.

If they are scratched or traumatisedthey can occasionally become infected and feel sore. They can bleed slightly if scratched.

What does molluscum contagiosum look like?

The molluscum contagiosum spots have the following characteristics:

Are small (from 2 to 6 mm across); however, they can grow larger than this, up to 10 to 20 mm

Are raised, and hemispherical (like a tiny dome), with a shiny surface

Usually they are skin coloured, though they can be red or pink

Their most striking feature is a central dimple

Sometimes areas of dry redness, like eczema, appear around the spots

There may be only one or two spots, and usually fewer than 20. However, they can be clustered together. The most common areas where these spots appear are on the face, chest, armpit, upper legs and genital area.

How will molluscum contagiosum be diagnosed?

Usually no tests are needed as the spots can easily be recognisedby a doctor. If a molluscum contagiosum spot becomes inflamed, it can look similar to a boil. If there is uncertainty of the diagnosis, then a skin biopsy can be carried out.

Can molluscum contagiosum be cured?

Yes. This condition usually clears by itself within 6 to 18 months. However, during this time there may be development of new ones whilst the old spots are clearing. Sometimes it may take a few years for the body to clear all the spots.

How can molluscum contagiosum be treated?

Usually no treatment is needed as mentioned above and the molluscum contagiosum spots clear. These areas may initially look white, pink- purple which fade over time.

There are a few treatments which may help to speed up the process of the clearance of these spots. However, this is dependent on the age of the person affected. Many of these treatments are painful and this must be taken into consideration as molluscum contagiosum is a harmless and self-resolving condition. Furthermore, it is thought that some treatments can increase the risk of scarring from this condition. There is no research evidence that any one treatment is better than others at clearing molluscum contagiosum.

If active treatment is needed, there are several possibilities:

There are a range of topical therapies used which includes, salicyclic acid and potassium hydroxide. These work by irritating the spots and causing them to become inflamed. The immune system then detects the virus and is able to clear the spots. The medication needs to be applied carefully to prevent unnecessary skin irritation. Sometimes a small scar / pallor of the skin can occur after resolution.

The spots can be frozen with liquid nitrogen (cryotherapy) at intervals until they are clear.

The spots can be scraped off with a sharp instrument (curettage) after local anaesthetic injectionby the general practitioner or dermatologist.

A hospital eye specialist can deal with spots on the eyelids.

A cream containing a chemical that affects the immune system (imiquimod) has been used for molluscum contagiosum, but it is not licensed for the condition and some research studies have shown that it is not effective.

Squeezing the spots is not recommended anymore as it can result in scarring and also risk spreading the spots to others part of the body

It is not advisable to cut the top layer of these spots as they may spread the virus or leave slight scars, especially if they get infected afterwards.

Self Care (What can I do?)

You should make every effort not to pass the infection on to others, particularly those in your family. Stick to your own towel, flannel, clothing and bedding. However children with molluscum contagiosum need not be kept off school, nor should they be barred from swimming, etc.

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel

BRITISH ASSOCIATION OF DERMATOLOGISTS
PATIENT INFORMATION LEAFLETPRODUCED MAY 2008
UPDATED AUGUST 2011, AUGUST 2014, AUGUST 2015, OCTOBER 2018
REVIEW DATE OCTOBER 2021